| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2345 GRAND BLVD SUITE 400 KANSAS CITY, MO 64108 | SUN LIFE ASSURANCE COMPANY OF CANADA | $49K | $0 | $49K | 5.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $7K | $7K | 1.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE INC | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | HM LIFE INSURANCE COMPANY | $0 | $5K | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 11TH FLOOR ROLLING MEADOWS, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $879 | $879 | 1.15% |
| ESSEX AGENCY LIFE CORPORATION3 Filed as: ESSEX AGENCY LIFE CORP | 1233 SHELBURNE ROAD STE C2A BURLINGTON, VT 05403 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $4K | $4K | 9.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GALLAGHER BENEFIT SERVICES INC EIN 38-1082080 NONE | Insurance agents and brokers Service code 22 | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | $63K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,803 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,836 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,314 | $959K |
| Vision | HM LIFE INSURANCE COMPANY | 1,934 | $91K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,794 | $684K |
| Long-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 526 | $225K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,794 | $638K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,934 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.